title: Invasiveness and malignant potential of pulmonary lesions presenting as pure ground-glass opacities.
abstract: OBJECTIVE
  We retrospectively investigated the pathological diagnoses of pulmonary lesions presenting as pure ground-glass opacities (GGOs) to evaluate the risk of invasive malignancy.
  
  
  METHODS
  We examined 191 GGO lesions, including 114 pure GGO and 77 mixed lesions, in 160 patients who underwent resection between January 2008 and December 2010.
  
  
  RESULTS
  Of the 114 pure GGO lesions, 14 (12%) were diagnosed as invasive lung cancer and 16 (14%) as minimally invasive adenocarcinoma. Twenty-one lesions exhibited pleural indentation on high-resolution computed tomography (HRCT), and 5 of these were diagnosed as invasive cancer, indicating an invasive tendency of pure GGO lesions with pleural indentation (odds ratio, 2.64). Of 14 pure GGO lesions positive on positron emission tomography (PET), 8 were diagnosed as invasive lung cancer, indicating an invasive tendency of pure GGO lesions with PET positivity (odds ratio, 16.0; p <0.001; sensitivity, 67%; specificity, 89%).
  
  
  CONCLUSIONS
  Invasive lung cancer accounted for 12% of the pure GGO lesions. Pure GGO lesions should be carefully monitored by periodic chest computed tomography, and surgical resection is recommended when they exhibit pleural indentation on HRCT or positivity on PET.
authors.affiliation: Department of Thoracic Surgery, Toranomon Hospital, Minato-ku, Tokyo, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Ichinose
authors.forename: Tadasu
authors.initials: T
authors.lastname: Kohno
authors.forename: Sakashi
authors.initials: S
authors.lastname: Fujimori
authors.forename: Takashi
authors.initials: T
authors.lastname: Harano
authors.forename: Souichiro
authors.initials: S
authors.lastname: Suzuki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Fujii
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D000077192:Adenocarcinoma of Lung; D002288:Adenocarcinoma, Mucinous / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D002278:Carcinoma in Situ / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D018196:Carcinoma, Adenosquamous / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D016009:Chi-Square Distribution; D018450:Disease Progression; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D061330:Multidetector Computed Tomography; D009361:Neoplasm Invasiveness; D016017:Odds Ratio; D010994:Pleura / Q000000981:diagnostic imaging; D011013:Pneumonectomy / Q000379:methods; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D020775:Thoracic Surgery, Video-Assisted; D047368:Tumor Burden